Prospective trials of surgical versus nonsurgical treatment in children with nonobstructive vesico-ureteral reflux and urinary tract infection are referred. Available data do not yet document significant differences of frequency of urinary tract infections, of morphological and functional renal damage, and of blood pressure under the conflicting treatment regimens. The frequency of acute pyelonephritis seems to decrease after surgical reflux resolution beyond the first postoperative weeks. Ongoing two studies are promising future scientific rather than present biased basis for individual therapeutic decisions after further increase of patient numbers resp. further accumulation of observation time.